Unlike withdrawal from dependencies on alcohol or benzodiazepines, heroin withdrawal isn’t life-threatening – but it is so horrific that many addicts are drawn back to the drug and overdose, the article notes. Because withdrawal is not directly deadly, most insurance companies won’t pay for inpatient rehab, either claiming that the addict does not meet the “criteria for medical necessity” — that inpatient care would be an inappropriate treatment — or requiring that the user first try outpatient rehab, the article says.

Of the 23.1 million Americans who needed treatment for drugs or alcohol in 2012, only 2.5 million people received care at a specialty facility, the article says, citing data from the Substance Abuse and Mental Health Services Administration.

As of 2009, around 2.3 million Americans suffered from addiction to opioids such as heroin or the prescription drug oxycodone, and new research shows that many of these people aren’t getting the treatment they need, according to this article. The massive uptick in opiate addiction has resulted in a major gap between current treatment options and evidence-based practices, the article says, citing an article published in the journal Health Affairs.

Excessive regulation presents the biggest barrier for treatment in the U.S., the article says. In addition, although maintenance treatment with methadone is the dominant form of treatment for opioid dependence throughout most of the developed world, detox is still a popular option, particularly in the U.S. – even though it is ineffective in getting and keeping people off of opioids, the article says.